India’s healthcare system still fails millions, Lancet Commission calls for citizen‑centred roadmap. In a landmark report released on January 22, 2026, the Lancet Commission on a Citizen‑Centred Health System for India highlighted that despite rapid expansion of health schemes, hospitals and digital platforms, the country’s public health infrastructure remains fragmented and ineffective for the average citizen.
Background / Context
Universal Health Coverage (UHC) has been a flagship promise of the Indian government for over a decade. Yet, a nationwide survey of nearly 50,000 households across 29 states reveals that patients continue to travel long distances, repeat investigations, and spend heavily on medicines and diagnostics even when enrolled in government schemes. The report underscores that the gap between policy and lived experience is now the central health challenge for India.
Public health spending remains below 2% of GDP, while insurance schemes such as Pradhan Mantri Jan Arogya Yojana (PM‑JAY) focus mainly on hospitalisation. Outpatient care, medicines and diagnostics—costs that drive most out‑of‑pocket expenditure—are poorly protected. The Commission’s findings point to weak implementation, poor coordination, and governance gaps as the main culprits.
Key Developments
The Lancet Commission’s citizen‑centred roadmap is built on four pillars:
- Rebuilding the public health system as the backbone of UHC, ensuring nationwide reach from community health workers to tertiary hospitals.
- Strengthening primary care through Ayushman Arogya Mandirs and integrated public‑private partnerships.
- Improving governance and accountability by streamlining referral systems and reducing staff shortages.
- Aligning financing with patient needs by expanding coverage for outpatient services, medicines and diagnostics.
Commission co‑chair Vikram Patel, Professor at Harvard Medical School, stated, “India can still turn UHC from a promise into a lived reality—if it fixes how care is delivered, not just how it is announced.” The report also highlights stark variation in performance across 687 districts, showing that identical national policies produce very different outcomes depending on local capacity and the strength of primary care.
Impact Analysis
For students and young professionals, the report’s implications are far‑reaching. Many rely on public health facilities for routine check‑ups, vaccinations and chronic disease management. The current fragmentation means:
- Long waiting times and repeated tests increase stress and reduce academic productivity.
- High out‑of‑pocket costs can deplete savings, forcing students to take loans or cut back on essential expenses.
- Limited access to quality diagnostics in rural areas hampers early detection of diseases, affecting long‑term health outcomes.
Moreover, the report’s emphasis on citizen‑centred care signals a shift toward patient‑first policies. Universities and student unions may need to advocate for better health infrastructure on campus and in nearby communities.
Expert Insights / Tips
Industry leaders echo the Commission’s focus on primary care and coordination. Dr. Harsh Mahajan, Founder & Chairman of Mahajan Imaging & Labs, advises:
“Strengthening preventive and primary care through Ayushman Arogya Mandirs is key. Students should actively engage with local health workers to understand available services and report gaps.”
Dr. Dharminder Nagar, MD of Paras Health, adds:
“Even in states with lower out‑of‑pocket spending, patients still face high costs due to fragmented delivery. Students should seek out public‑private partnerships that offer subsidised diagnostics.”
Practical steps for students:
- Register with local health schemes and keep digital records of all visits.
- Use government portals to track empanelment status of nearby hospitals.
- Advocate for mobile health vans and tele‑medicine services on campus.
- Participate in health awareness drives to improve community knowledge of available services.
Looking Ahead
The Commission’s roadmap sets a clear path for the next five years. Key milestones include:
- Increasing public health spending to 3% of GDP by 2028.
- Expanding PM‑JAY coverage to include outpatient care and essential medicines.
- Implementing a nationwide digital health ID to streamline referrals and data sharing.
- Establishing performance metrics for district health offices to ensure accountability.
Policymakers are expected to release a detailed implementation plan in the upcoming fiscal budget. Meanwhile, civil society groups and student bodies can play a pivotal role by monitoring progress and holding authorities accountable.
For students, the evolving landscape offers both challenges and opportunities. By staying informed and actively engaging with health initiatives, they can help shape a more equitable and efficient India healthcare system.
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